Paper Chase 4 – Can We Expel Kidney Stones

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Nurses Edition Commentary

Mizuho Morrison, DO, Lisa Chavez, RN, and Kathy Garvin, RN
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Brook W. -

Here is where our urology group stands on the issue after attending their society meeting in San Diego this year;

AUA Guidelines 2016: Surgical Management of Renal and Ureteral Stones.

Research on Calculus Kinetics Society (ROCK)

Following the 2014 annual meeting, an important study of medical expulsive therapy (MET) for patients with ureteral stones—the SUSPEND trial—was released by a group of investigators in the United Kingdom. This study, which was a large and well-designed effort, called into question the efficacy of MET, as it did not find any beneficial effect with MET. This year’s annual meeting explored this subject in great detail, with debates both at the Plenary as well as the ROCK Society. The consensus of these debates was that the primary outcome of the SUSPEND trial (absence of need for intervention) was different than that of all previous studies of MET (radiographic confirmation of stone passage), and the study populations were somewhat different as well (the SUSPEND cohort had an 80% spontaneous passage rate, as compared with a 53% spontaneous passage rate in all previous studies of MET).

Therefore, the recommendation to utilize MET still stands.

This practice is also reflected in the Surgical Management of Stones guidelines document that was released at the annual meeting

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